Neuro CVA

Question 1

2 types of stroke

Answer 1

1. Ischemic

2. Hemorrhagic

Question 2

3 most common locations for lesions

Answer 2

1. Origin of the common carotid artery
2. Main bifurcation of the middle cerebral artery
3. Junction of the vertebral arteries with the basilar artery

Question 3

MCA incidence

Answer 3

Most commonly involved

Question 4

MCA sx

Answer 4

CL hemiplegia, mostly UE involvement, loss of sensation primarily in arm and face, homonymous hemianopsia common

Question 5

MCA sx if infarction in dominant L hemisphere

Answer 5

Aphasia, apraxia

Question 6

MCA sx if in main stem

Answer 6

Global aphasia

Question 7

ACA incidence

Answer 7

Rare

Question 8

ACA sx

Answer 8

LE more freq affected resulting in CL hemiplegia and sensory loss. Mental confusion, aphasia, CL neglect if involvement extensive on the dominant side

Question 9

PCA sx

Answer 9

Persistent pain syndrome of CL pain and temp sensory loss can occur. Homonymous hemianopsia, aphasia, and thalamic pain syndrome also can result from occlusion

Question 10

Vertebral-basilar artery prognosis

Answer 10

Often results in death from the edema associated with the infarct

Question 11

Vertebral-basilar artery sx

Answer 11

If lesion affects the pons: quadripresis and bulbar palsy or a “locked-in” state whereby the pt can communicate only by blinking. Other sx can include vertigo, coma, diplopia, nausea, dysphagia, ataxia

Question 12

Anterior inferior cerebellar sx

Answer 12

Unilateral deafness, CL loss of pain and temp, paresis of lateral gaze, unilateral Horner’s syndrome, ataxia, vertigo, nystagmus

Question 13

Superior cerebellar sx

Answer 13

Severe ataxia, dysarthria, dysmetria, CL loss pain and temp

Question 14

Posterior inferior cerebellar sx

Answer 14

Wallenberg’s syndrome (vertigo, nausea, hoarseness, dysphagia, ptosis, decreased impairment of sensation in the IP face and CL torso and limbs. Horner’s may also appear

Question 15

Stages of recovery following stroke - Early/Flaccid

Answer 15

Flaccidity is present early, often with no voluntary movement

Question 16

Stages of recovery following stroke - Mid

Answer 16

Spasticity, hyperreflexia, synergies

Question 17

Stages of recovery following stroke - Late

Answer 17

Isolated and advanced movement patterns become possible

Question 18

Stages of recovery following stroke - Stage I

Answer 18

Flaccid, no limb movement

Question 19

Stages of recovery following stroke - Stage II

Answer 19

Synergies may appear. Spasticity begins to develop. Minimal voluntary movement.

Question 20

Stages of recovery following stroke - Stage III

Answer 20

Spasticity increases and may become severe. Voluntary control of movement synergies appears

Question 21

Stages of recovery following stroke - Stage IV

Answer 21

Some movement independent of the synergies. Spasticity begins to decline.

Question 22

Stages of recovery following stroke - Stage V

Answer 22

If pt progresses, synergies no longer dominate and movement becomes more complex

Question 23

Stages of recovery following stroke - Stage VI

Answer 23

Spasticity is gone. Coordination and movement approach normal